Organization
GREEN RIVER HEART INSTITUTE, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER J. HAVELDA M.D. (PRESIDENT)
(270) 688-0808
Entity
Organization
Contact information
Practice address
815 E PARRISH AVE, SUITE 240, OWENSBORO, KY 42303-3222
(270) 688-0808
(270) 683-5806
Mailing address
815 E PARRISH AVE, SUITE 240, OWENSBORO, KY 42303-3222
(270) 688-0808
(270) 683-5806
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100006330A
—
IN
01
—
15E1
ANTHEM BCBS
KY
05
—
65935561
—
KY
Enumeration date
08/20/2006
Last updated
07/23/2008
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